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The Effect of Allogenic Versus Autologous Fecal Microbiota Transfer on Symptoms, Visceral Perception and Fecal and Mucosal Microbiota in Irritable Bowel Syndrome: A Randomized Controlled Study
Örebro universitet, Institutionen för medicinska vetenskaper. (Nutrition-Gut-Brain Interactions Research Centre)ORCID-id: 0000-0002-4204-6811
Örebro universitet, Institutionen för medicinska vetenskaper. (Nutrition-Gut-Brain Interactions Research Centre)ORCID-id: 0000-0003-3887-9519
Örebro universitet, Institutionen för medicinska vetenskaper. (Nutrition-Gut-Brain Interactions Research Centre)ORCID-id: 0000-0002-7173-5579
Human Microbiome Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
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2019 (Engelska)Ingår i: Clinical and Translational Gastroenterology, ISSN 2155-384X, E-ISSN 2155-384X, Vol. 10, nr 4, artikel-id e00034Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

OBJECTIVES: Fecal microbiota transfer (FMT) is suggested as a potential treatment for patients with irritable bowel syndrome (IBS). We aimed to study the effect of allogenic and autologous FMT on IBS symptoms, visceral sensitivity, and compositional changes in fecal and mucosa-adherent microbiota.

METHODS: Seventeen patients with IBS were randomized either to receive fecal material from a healthy donor (allogenic) or to receive their own fecal material (autologous). The fecal material was administered into the cecum by whole colonoscopy after bowel cleansing.

RESULTS: No significant differences were found between the allogenic and the autologous FMT regarding symptom scores. However, symptom scores of patients receiving allogenic fecal material significantly decreased after FMT compared with baseline (P 5 0.02), which was not the case in the autologous group (P50.16). Visceral sensitivity was not affected except for a small beneficial effect on urge scores in the autologous group (P < 0.05). While both fecal and mucosa-adherent microbiota of some patients shifted to their respective donor’s fecal microbiota, some patients showed no relevant microbial changes after allogenic FMT. Large compositional shifts in fecal and mucosa-adherent microbiota also occurred in the autologous group.

CONCLUSIONS: This study showed that a single FMT by colonoscopy may have beneficial effects in IBS; however, the allogenic fecal material was not superior to the autologous fecal material. This suggests that bowel cleansing prior to the colonoscopy and/or processing of the fecal material as part of the FMT routine contribute to symptoms and gut microbiota composition changes in IBS.

Ort, förlag, år, upplaga, sidor
Nature Publishing Group, 2019. Vol. 10, nr 4, artikel-id e00034
Nationell ämneskategori
Gastroenterologi
Forskningsämne
Medicin
Identifikatorer
URN: urn:nbn:se:oru:diva-74035DOI: 10.14309/ctg.0000000000000034ISI: 000466787000001PubMedID: 31009405OAI: oai:DiVA.org:oru-74035DiVA, id: diva2:1313864
Forskningsfinansiär
Stiftelsen Svensk Näringsforskning
Anmärkning

Funding Agencies:

SIAM Gravitation Grant  024.002.002 

Spinoza 2008 Award of the Netherlands Organization for Scientific Research (NWO) 

Tillgänglig från: 2019-05-06 Skapad: 2019-05-06 Senast uppdaterad: 2019-12-20Bibliografiskt granskad
Ingår i avhandling
1. Faecal Microbiota Transfer in Irritable Bowel Syndrome and Collagenous Colitis: Clinical outcomes and host-microbe interactions
Öppna denna publikation i ny flik eller fönster >>Faecal Microbiota Transfer in Irritable Bowel Syndrome and Collagenous Colitis: Clinical outcomes and host-microbe interactions
2020 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Faecal microbiota transfer (FMT) aims at restoring a disturbed gut microbiotaby introducing faecal material from a healthy donor into a patient’s intestine. This approach is known as a safe and effective treatment in patients with recurrent Clostridioides difficile infection. This thesis describes the outcomes of two clinical studies in which FMT was investigated as a therapy for irritable bowel syndrome (IBS) patients andin collagenous colitis (CC) patients. Paper I showed that there were no significant differences in IBS symptom scores between patients receiving faecal material from a healthy donor (allogenic FMT) and patients receiving their own faecal material back (autologous FMT). However, unlike autologous FMT, allogenic FMT significantly decreased symptom scores compared to baseline. Additionally, allogenic FMT wasshown to alter the faecal as well as the mucosal microbiota of the IBSpatients. However, also the autologous FMT had an effect on the faecal and mucosal microbiota indicating that the bowel cleansing and/or theprocessing of the autologous faecal material affected the gut microbiota. Paper II showed that the allogenic FMT evoked a clearly different host response in IBS patients than the autologous FMT. Paper III showedthat allogenic FMT did not result in altered faecal metabolite profilesbut in disturbed interactions between the gut microbiota and its metabolites compared to autologous FMT. Paper IV describes the outcomes of the second clinical study in which repeated FMTs resulted inless diarrhoea in a subset of the treated CC patients.

Although symptoms improved in both clinical studies, the introduction of a new microbiota by FMT did not seem to be the miracle curefor IBS and CC. However, a subset of patients could benefit from FMT, and a future challenge is to identify this subset. The findings of this thesis are essential for designing further studies aimed at increasing FMT efficacy.

Ort, förlag, år, upplaga, sidor
Örebro: Örebro University, 2020. s. 76
Serie
Örebro Studies in Medicine, ISSN 1652-4063 ; 204
Nyckelord
Faecal microbiota transfer, irritable bowel syndrome, collagenous colitis, gut microbiota, visceral sensitivity, host-microbe interactions, gene expression, metabolites
Nationell ämneskategori
Allmänmedicin
Identifikatorer
urn:nbn:se:oru:diva-77633 (URN)978-91-7529-316-5 (ISBN)
Disputation
2020-01-17, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 09:00 (Engelska)
Opponent
Handledare
Tillgänglig från: 2019-10-28 Skapad: 2019-10-28 Senast uppdaterad: 2019-12-16Bibliografiskt granskad

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The Effect of Allogenic Versus Autologous Fecal Microbiota Transfer on Symptoms, Visceral Perception and Fecal and Mucosal Microbiota in Irritable Bowel Syndrome: A Randomized Controlled Study(824 kB)70 nedladdningar
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